Fatima Al Sayah1, Sumit R Majumdar2, Jeffrey A Johnson3. 1. Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), Department of Public Health Sciences, University of Alberta, Alberta, Canada. 2. Department of Medicine, University of Alberta, Alberta, Canada. 3. Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), Department of Public Health Sciences, University of Alberta, Alberta, Canada. Electronic address: jeff.johnson@ualberta.ca.
Abstract
OBJECTIVE: To examine the relationship of inadequate health literacy (HL) with changes in depressive symptoms, health-related quality of life and cardiometabolic outcomes in patients with type 2 diabetes mellitus recently screened positive for depression. METHODS: Secondary analysis of data from a clinical trial (N=154) that compared a collaborative team care model and enhanced usual care for primary care for patients with type 2 diabetes and depression. The exposure of interest was inadequate HL, defined as a total summative score of 9 or more on the 3 brief screening questions. Outcomes of interest were differences in the changes in depressive symptoms (Patient Health Questionnaire-9 (PHQ-9) at 12 months, health-related quality of life (short-form health survey 12 [SF-12]) and European Quality of Life-5 Dimensions questionnaire (EQ-5D), glycemic control (A1C), low-density lipoprotein cholesterol and systolic blood pressure. RESULTS: The average age of patients was 58 years; 56% were women and were predominantly white. Only a small proportion (n=24; 16%) had inadequate HL. In adjusted random effects models, there were no statistically significant or clinically important differences in all outcomes between the HL groups. The between-group differences in change over 1 year were -0.55 points for PHQ-9; 0.76 points for physical and 0.56 points for mental summaries of the SF-12; 0.03 points for EQ-5D; -0.17 for A1C; -0.08 mmol/L for low-density lipoprotein; and -1.94 mm Hg for systolic blood pressure. CONCLUSIONS: Among primary care patients with type 2 diabetes who had been screened recently as being positive for depression, it is unlikely that HL impacts health outcomes over 1 year.
RCT Entities:
OBJECTIVE: To examine the relationship of inadequate health literacy (HL) with changes in depressive symptoms, health-related quality of life and cardiometabolic outcomes in patients with type 2 diabetes mellitus recently screened positive for depression. METHODS: Secondary analysis of data from a clinical trial (N=154) that compared a collaborative team care model and enhanced usual care for primary care for patients with type 2 diabetes and depression. The exposure of interest was inadequate HL, defined as a total summative score of 9 or more on the 3 brief screening questions. Outcomes of interest were differences in the changes in depressive symptoms (Patient Health Questionnaire-9 (PHQ-9) at 12 months, health-related quality of life (short-form health survey 12 [SF-12]) and European Quality of Life-5 Dimensions questionnaire (EQ-5D), glycemic control (A1C), low-density lipoprotein cholesterol and systolic blood pressure. RESULTS: The average age of patients was 58 years; 56% were women and were predominantly white. Only a small proportion (n=24; 16%) had inadequate HL. In adjusted random effects models, there were no statistically significant or clinically important differences in all outcomes between the HL groups. The between-group differences in change over 1 year were -0.55 points for PHQ-9; 0.76 points for physical and 0.56 points for mental summaries of the SF-12; 0.03 points for EQ-5D; -0.17 for A1C; -0.08 mmol/L for low-density lipoprotein; and -1.94 mm Hg for systolic blood pressure. CONCLUSIONS: Among primary care patients with type 2 diabetes who had been screened recently as being positive for depression, it is unlikely that HL impacts health outcomes over 1 year.
Keywords:
compétence informationnelle en santé; depression; diabetes; diabète; dépression; glycemic control; health literacy; health-related quality of life; qualité de vie liée à la santé; régulation de la glycémie
Authors: Maria Panagioti; Suzanne M Skevington; Mark Hann; Kelly Howells; Amy Blakemore; David Reeves; Peter Bower Journal: Qual Life Res Date: 2018-01-10 Impact factor: 4.147